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Revista Portuguesa de Cardiologia
Article . 2013 . Peer-reviewed
License: CC BY NC ND
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Revista Portuguesa de Cardiologia
Article
License: CC BY NC ND
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Revista Portuguesa de Cardiologia
Article . 2013
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Miocardiopatia hipocalcémica

Authors: Patrício Aguiar; Diogo Cruz; Rita Ferro Rodrigues; Lígia Peixoto; Francisco Araújo; José Luís Ducla Soares;

Miocardiopatia hipocalcémica

Abstract

Resumo: A associação entre hipocalcemia e insuficiência cardíaca é rara. Na literatura existem poucos casos descritos com esta associação, tendo-se estabelecido a entidade miocardiopatia hipocalcémica.Relata-se o caso de uma mulher, de 61 anos, sem antecedentes médicos relevantes. Internada por um quadro com um mês de evolução de dispneia de esforço, ortopneia e edema dos membros inferiores de agravamento progressivo. À observação, apresentava espasmos musculares difusos, sem sinais de tetania latente.Da investigação complementar destacavam-se cálcio ionizado 0,54 mmol/l (1,12-1,30), fósforo 9,8 mg/dl, hormona paratiroideia  3 000 U/l, com função tiroideia normal. O eletrocardiograma revelava um prolongamento do intervalo QT e um padrão de sobrecarga do ventrículo esquerdo e os marcadores de necrose miocárdica eram negativos. O ecocardiograma demonstrava alterações segmentares da contratilidade miocárdica, a coronariografia era normal e na TC-CE identificavam-se calcificações dos núcleos basais e substância branca.Iniciou terapêutica diurética e de reposição do cálcio com remissão completa da insuficiência cardíaca, sem necessidade de terapêutica específica para a mesma após normalização da calcemia. Abstract: The association between hypocalcemia and heart failure is rare. There are few reported cases in the literature of this association, which is termed hypocalcemic cardiomyopathy.We report the case of a 61-year-old woman with no relevant medical history, admitted for progressively worsening exertional dyspnea, orthopnea and edema of the lower limbs for a previous month. Physical examination showed diffuse muscle spasms, with no signs of latent tetany.Further investigation revealed ionized calcium 0.54 mmol/l (normal 1.12-1.30), phosphorus 9.8 mg/dl, parathyroid hormone 3000 U/l, with normal thyroid function. The electrocardiogram showed long QT interval and a pattern of left ventricular overload, and myocardial biomarkers were negative. The echocardiogram revealed regional wall motion abnormalities, coronary angiography was normal and a cranial CT scan detected calcification of basal ganglia and white matter.She started diuretic and calcium replacement therapy which resulted in complete clinical recovery, with no need for heart failure therapy after normalization of serum calcium. Palavras-chave: Insuficiência cardíaca, Hipoparatiroidismo, Hipocalcemia, Miocardiopatia hipocalcémica, Keywords: Cardiac failure, Hypoparathyroidism, Hypocalcemia, Hypocalcemic cardiomyopathy

Keywords

RC666-701, Diseases of the circulatory (Cardiovascular) system

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
10
Top 10%
Top 10%
Average
gold